ES2608390T3 - Surgical device that has a slide and a drive beam with a latch - Google Patents

Abstract

A surgical stapling apparatus, comprising: an actuation device (12) that includes an elongated rod (16); a tool assembly (10, 110) disposed at a distal end (114) of the rod, the tool assembly including a first jaw member (113) supporting a cartridge assembly (115) having a plurality of fasteners or clips (111) and a slide located to eject the fasteners from the cartridge assembly, and a second jaw member (117) supporting an anvil (119), the first jaw member being movable with respect to the first jaw member between positions separate and approximate; a slide pusher assembly (174) that includes a slide pusher (178) having a distal end configured to be applied to the slide of the cartridge assembly; and a drive beam assembly (134); characterized in that the drive beam assembly includes a latch assembly (140) having a latch (150) releasably coupled to the slide pusher assembly, in which the distal translation of the drive beam assembly from a retracted position towards an advanced position it makes the movement of the first and second jaw members towards the approximate position and unlatches the latch, of the latch assembly, of the sliding pusher assembly to facilitate the distal movement of the sliding pusher regardless of the beam assembly of actuation and in which the distal movement of the slide pusher independently of the drive beam assembly advances the slide pusher and the slide of the cartridge assembly to eject the plurality of fasteners from the cartridge assembly.

Description

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DESCRIPTION

Surgical device that has a slide and a drive beam with a latch

Background

Technical field

This description refers to a surgical device. More specifically, the present description refers to a surgical stapler that includes trigger assemblies configured to control the distance of tissue separation between jaw members of the stapler when the jaw members are in a clamping configuration and the surgical stapler is fired. .

Description of the related technique

Surgical staplers configured to hold and staple tissue are known. Such staplers may include a tool assembly that is supported at a distal end of a stapler rod. The tool assembly may include, for example, an anvil and a cartridge that includes a plurality of staples or fasteners that are configured to staple tissue (eg, occlusion of a vascular structure during a transplant operation).

To staple with such staplers, the tissue can be placed between the cartridge and the anvil, and the anvil can be approached toward the cartridge to hold the tissue. Once the tissue is secured, the stapler can be fired to advance the stapler drive assembly distally through the cartridge to eject the plurality of surgical fasteners sequentially from the cartridge to the tissue to be stapled.

In addition to the mechanisms indicated for firing the plurality of fasteners, conventional staplers may also include a structure configured to control the distance of tissue separation between the anvil and the tool assembly cartridge during stapler firing.

US 5,865,361 shows a surgical stapler according to the preamble of claim 1.

Although the above-mentioned staplers may be satisfactory for the above uses, there may be a need for a simpler design to fire surgical fasteners and / or approximate a cartridge to an anvil. There is also a need for a firing set that takes up less space, as well as a need for a set and / or an alternative approach method.

Compendium

One aspect of the present description provides a surgical stapling apparatus. The surgical stapling apparatus includes a drive device comprising an elongated rod. A tool assembly is disposed at a distal end of the rod. The tool assembly can be removably coupled to the distal end of the rod of the surgical stapling apparatus. The tool assembly includes a first jaw member that supports a cartridge assembly that has a plurality of surgical fasteners, and a second jaw member that supports an anvil. The first jaw member is movable with respect to the second jaw member between a separate position and an approximate position. One of the first and second jaw members includes a cantilever at a proximal end thereof. The cantilever can be in the form of a bridge that extends transversely in relation to a defined longitudinal axis through the rod of the surgical stapling apparatus. A set of trigger cam bars is slidably disposed within the tool assembly. The trigger cam bar assembly includes a cam surface configured to be applied to the overhang to move the first and second jaw members toward the approximate position and a distal end configured to deploy the plurality of surgical fasteners from the cartridge as the Shooting cam bar assembly is moved distally through the tool set.

The trigger cam bar assembly may include a first trigger cam bar that has an elongated configuration and a distal position that defines the cam surface. The surgical stapler may also include a second firing cam bar having an elongated configuration and a distal portion defining the cam surface, the second firing cam bar being seated within the first firing cam bar. The cartridge may include a plurality of pushers, and the distal portions of the first and second trigger cam bars are configured to contact the plurality of pushers of the cartridge to deploy the plurality of surgical fasteners from the cartridge.

The cam surface of the set of trigger cam bars may include a first cam part disposed distally and at an angle with respect to the second cam part. The second cam part of the cam surface can be narrowed inward toward the proximal end of the trigger cam bar assembly.

An elastic member may be arranged in the cartridge to load or push the cartridge radially out of the anvil. The elastic member may include a proximal end that is coupled to the proximal end of the

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cartridge and a distal end that is positioned to contact at least a part of the anvil. The proximal end of the elastic member may include two parts of fingers that are seated within two corresponding openings defined at the proximal end of the cartridge.

One aspect of the present invention provides a recharge configured for use with a surgical stapling device. The reload includes a rod comprising a proximal end that is adapted to engage a surgical apparatus, and a distal end. A tool assembly is disposed at the distal end of the rod. The tool assembly includes a first jaw member that supports a cartridge assembly that has a plurality of surgical fasteners, and a second jaw member that supports an anvil. The first jaw member is movable with respect to the second jaw member between a separate position and an approximate position. One of the first and second jaw members includes a cantilever at a proximal end thereof. The cantilever can be in the form of a bridge that extends transversely with respect to a longitudinal axis defined through the rod of the surgical stapling apparatus. A first set of trigger cam bars is slidably disposed within the tool assembly. The trigger cam assembly includes a cam surface configured to be applied to the overhang to move the first and second jaw members toward the approximate position and a distal end configured to deploy the plurality of surgical fasteners from the cartridge as the trigger cam assembly is moved distally through the tool assembly.

One aspect of the present description provides a surgical stapling apparatus. The surgical stapling apparatus includes a drive device comprising an elongated rod. A tool assembly is disposed at a distal end of the rod. The tool assembly is removably attachable to the distal end of the stem of the surgical stapling device. The tool assembly includes a first jaw member that supports a cartridge assembly having a plurality of fasteners and a slide located to eject the fasteners from the cartridge assembly and a second jaw member that supports an anvil. The first jaw member is movable with respect to the second jaw member between separate and approximate positions. A slide pusher assembly includes a slide pusher having a distal end configured to be applied to the slide of the cartridge assembly. A drive beam assembly includes a latch assembly having a latch releasably coupled to the slide pusher assembly. The distal translation of the drive beam assembly from a retracted position to an advanced position effects the movement of the first and second jaw members to the approach position and unlatches the latch of the slide pusher assembly latch assembly to facilitate the distal movement of

Sliding pusher regardless of the drive beam assembly. The distal movement of

Sliding pusher regardless of the drive beam assembly also advances the distal end of the sliding slide pusher with the slide of the cartridge assembly to eject the plurality of fasteners from the cartridge assembly.

The latch assembly may include a collar that is coupled to a proximal end of the beam assembly of

drive and may include an opening configured to receive a support member of the assembly of

sliding pusher. The support member of the slide pusher assembly may include at least one opening that is configured to receive the latch of the latch assembly.

The drive beam assembly may include an I-beam (double T) having a side wall that defines a notch, the sliding pusher being received in the notch. The I-beam may be positioned to act as a cam for the first and second jaw members towards the approximate position when the drive beam assembly is moved distally.

The latch assembly may include at least one spring configured to load the latch of the latch assembly into the opening defined in the support member of the slide pusher assembly. The opening of the support member may be defined by a proximal wall portion of the slide pusher assembly. The proximal wall portion may be configured to be applied to the latch of the latch assembly to keep the drive beam assembly and the sliding pusher coupled between sf.

The elongated rod may include upper and lower housing parts, and at least one of the upper and lower housing parts includes at least one stop or stop member configured to contact a proximal end of the collar of the latch assembly when the assembly of drive beam is moved distally. The latch may include a lateral displacement extension, and in which at least one of the upper and lower housing parts of the elongated rod includes at least one ramp portion configured to be coupled by the lateral displacement extension to effect the movement of the latch out of engagement with the proximal wall part when the drive beam assembly is moved distally so that the sliding pusher assembly is allowed to move distally with respect to the drive beam assembly.

An elastic member may be arranged in the cartridge to load the cartridge assembly radially out of the anvil. The elastic member may include a lower part that is coupled to a proximal end of the cartridge and an upper part that is positioned to contact at least a part of the anvil. The bottom of the

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Elastic member may be seated within a corresponding groove defined at the proximal end of the cartridge assembly. The lower part of the elastic member may include at least one fastener that engages a corresponding depression disposed in the cartridge assembly adjacent to the groove.

One aspect of the present invention provides a recharge configured for use with a surgical stapling device. The reload includes a rod that includes a proximal end and a distal end. The proximal end is adapted to fit a surgical device. A tool assembly is disposed at the distal end of the rod. The tool assembly includes a first jaw member that supports a cartridge assembly having a plurality of fasteners and a slide located to eject the fasteners from the cartridge assembly, and a second jaw member that supports an anvil. The first jaw member is movable with respect to the second jaw member between separate and approximate positions. A slide pusher assembly includes a slide pusher having a distal end configured to be applied to the slide of the cartridge assembly. A drive beam assembly includes a latch assembly having a latch releasably coupled to the slide pusher assembly. The distal translation of the drive beam assembly from a retracted position towards an advanced position effects the movement of the first and second jaw members towards the approximate position and disengages the latch of the slide pusher assembly latch assembly to facilitate movement distal of the slide thrust regardless of the drive beam assembly. The distal movement of the slide pusher regardless of the drive beam assembly also advances the distal end of the slide pusher to engage with the slide of the cartridge assembly to eject the plurality of fasteners from the cartridge assembly.

Brief description of the drawings

The invention is defined in the characterizing part of the attached claim 1. That is described in relation to Figures 21 to 44.

In the following, various embodiments of the present invention are described with reference to the drawings, in which:

Figure 1A is a perspective view of a recharge according to an embodiment of the present invention, the recharge being configured for use with a surgical apparatus that is schematically shown in Figure 1A;

Figure 1B is a perspective view of a type of surgical stapler that can be used with the recharge shown in Figure 1A;

Figure 2 is an exploded view of the refill shown in Figure 1A with separate parts;

Figure 3 is a perspective view of a set of trigger cam bars of the recharge shown in Figures 1 and 2;

Figure 4 is the indicated area of detail shown in Figure 3;

Figure 5 is a side view of the trigger cam bar assembly shown in Figure 3;

Figure 6 is an exploded view of the set of trigger cam bars shown in Figure 3 with separate parts;

Figure 7 is an indicated area of detail shown in Figure 1A;

Figure 8 is a perspective view of the refill shown in Figure 1 A with an outer tube of the refill removed;

Figure 9 is the indicated area of detail shown in Figure 8;

Figure 10 is a perspective view of the refill shown in Figure 1A with parts removed, illustrating the set of trigger cam bars coupled to a cartridge of a refill tool assembly;

Figure 11 is the indicated area of detail shown in Figure 10;

Figure 12 is a perspective view of the refill shown in Figure 1A with suppressed pairs, illustrating a cantilever of the cartridge in contact with the set of trigger cam bars;

Figure 13 is the indicated area of detail shown in Figure 12;

Figure 14 is a cross-sectional view taken along section line 14-14 of Figure 1A;

Figure 15 is the indicated area of detail shown in Figure 14;

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Figure 16 is a partial cross-sectional view of a distal end of the refill shown in Figure 1A, illustrating the set of trigger cam bars being moved through the cartridge to shoot cartridge holders;

Figure 17 is the indicated area of detail shown in Figure 16;

Figure 18 is a partial cross-sectional view of the distal end of the refill shown in Figure 15, illustrating a cam surface of the trigger cam assembly sliding along the cartridge overhang as the assembly of trigger cam bars are being displaced through the cartridge to fire cartridge holders;

Figure 19 is a partial cross-sectional view of the distal end of the refill shown in Figure 15, illustrating a pusher contact surface of the trigger cam assembly that pushes a cartridge pusher as the assembly of Shooting cam bars are being moved through the cartridge to fire cartridge holders;

Figure 20 is a partial cross-sectional view of the distal end of the recharge shown in Figure 15, which

illustrates the cam surface of the trigger cam bar assembly and the cantilever of the cartridge in contact between sf

to maintain a specific separation distance of the tissue between the cartridge and an anvil of the tool assembly;

Figure 21 is a perspective view of a recharge according to another embodiment of the present invention, the recharge being configured for use with the surgical apparatus shown schematically in Figure 1A;

Figure 22 is an exploded view of the refill shown in Figure 21 with separate parts;

Figure 23 is a perspective view of a refill cartridge assembly shown in Figure 21;

Figure 24 is an exploded view of the cartridge assembly shown in Figure 23, with separate parts;

Figure 25 is a perspective view of a second recharge jaw member shown in Figure 21;

Figure 26 is an exploded view of the second jaw member shown in Figure 25, with separate parts;

Figure 27 is a perspective view of a drive beam assembly and recharge latch assembly shown in Figure 21;

Figure 28 is an exploded view of the drive beam and latch assembly shown in Figure 27 with separate parts;

Figure 29 is a perspective view of the slide pusher assembly of the recharge shown in Figure 21;

Figure 30 is an exploded view of the slide pusher assembly shown in Figure 29, with separate parts;

Figure 31 is a partial perspective view of the recharge shown in Figure 21, with a distal end of the recharge shown in a non-fastened configuration;

Figure 32 is a partial perspective view of the recharge shown in Figure 21, with parts removed, illustrating the drive beam assembly and the latch assembly when the distal end of the recharge is in the non-fastened configuration shown in figure 31;

Figure 33 is the indicated area of detail shown in Figure 32;

Figure 34 is a cross-sectional view taken along section line 34-34 of Figure 31;

Figure 35 is the indicated area of detail shown in Figure 34;

Figure 36 is a partial perspective view of the recharge shown in Figure 21, with a distal end of the recharge shown in a fastened configuration;

Figure 37 is a partial perspective view of the recharge shown in Figure 21, with parts removed, illustrating the drive beam assembly and the latch assembly when the distal end of the recharge is in the fastened configuration shown in the figure 36;

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Figure 38 is the indicated area of detail shown in Figure 37;

Figure 39 is a perspective view of an upper rod portion of the refill shown in Figure 21;

Figure 40 is a cross-sectional view of the recharge shown in Figure 21, with the distal end of the recharge shown in the fastened configuration;

Figure 41 is the indicated area of detail shown in Figure 40;

Figure 42 is a partial perspective view of the recharge shown in Figure 21, with parts removed, illustrating the slide pusher assembly shown in Figure 29 when the slide pusher assembly is being fired;

Figure 43 is a cross-sectional view of the recharge shown in Figure 21, with the recharge shown in the configuration held and the slide pusher assembly being fired; Y

Figure 44 is the indicated area of detail shown in Figure 43.

Detailed description

Detailed embodiments of the present invention are described herein; however, the described embodiments are merely examples of the invention, which can be incorporated in various forms. Therefore, the specific structural and functional details described here are not to be construed as limiting, but simply as a basis for the claims and as a representative basis for teaching a person skilled in the art the varied use of the present invention in virtually any properly detailed structure.

Embodiments of the present invention are described in detail with reference to the figures of the drawings, in which the same reference numbers identify similar or identical elements. As used herein, the term "distal" refers to the part that is being described that is farther from a user, while the term "proximal" refers to the part that is being described that is closer to the user. Username.

Referring initially to Figure 1A, a recharge 10 according to the present invention is shown. The recharge 10 may be configured to be coupled to a variety of different surgical actuation devices, schematically shown as 12 in Figure 1A, including manually operated actuation devices, motorized actuation devices, etc. The surgical actuation device 12 includes a rod assembly 16 which has a distal end configured to releasably support the recharge 10.

In an embodiment illustrated in FIG. 1B, the surgical actuation device 12 is a manually operated stapler 212, which includes a handle assembly 214 and a rod assembly 216 that is coupled to, and supports, the recharge 10. The assembly of Handle 214 includes a pair of retract buttons 218 that are configured to return stapler 212 to a retracted configuration. For a more detailed description of the operation of the operative components of the stapler 212, reference is made to U.S. Pat. 5,865,361, granted to Milliman, of common property.

Figure 2 is a perspective view of the recharge 10, with the parts separated. The refill 10 includes an outer tube 18 housing a rod assembly 20 configured to couple the refill 10 to the rod assembly 16 of the actuation device 12 (see Figure 1A). The rod assembly 20 includes an upper housing part 22a and a lower housing part 22b which, when coupled to each other, house recharge components 10. The proximal ends 24a, 24b of the upper and lower parts 22a, 22b of They are configured to be releasably coupled with the distal end of the rod assembly 16 of the actuation device 12 (see, for example, the '361 patent). A distal end of the housing parts 22a, 22b of the rod assembly 20 supports upper and lower coupling members 26a, 26b, respectively. A distal end of each of the coupling members 26a, 26b is configured to pivotally engage upper and lower pivot portions 28a, 28b, respectively, of a pivot assembly 30 (see Figure 1A). An articulation arm 32 is slidably located within the upper and lower housing parts 22a, 22b and is configured to articulate an end assembly 14 of the actuator or recharge tool 10 in relation to the rod assembly 20.

The tool assembly 14 includes a first jaw member 13 that supports a cartridge 15 and a second jaw member 17 that supports an anvil 19. The first jaw member 13 is pivotally supported relative to the second jaw member 17 between separate and approximate positions. The cartridge 15 houses a plurality of pushers 9 and fasteners 11. A dissection tip 19a can be secured to a distal end of the anvil 19 to facilitate the positioning of the anvil 19 with respect to the tissue to be stapled. Such a dissection tip 19a is described in U.S. Pat. No. 8,348,123.

Referring also to Figures 3-6, the rod assembly 20 includes a set 34 of trigger cam bars that is releasably coupled with a central rod (not shown) of the actuation device 12. The bar assembly 34 trigger cam is set to move cartridge 15 from the separate position

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(Figure 1B) towards the anvil 19 to the approximate position (Figure 18) as the set 34 of trigger cam bars is moved distally through the tool assembly 14. A distal end of the set 34 of bar bars trigger cam is also configured to push the plurality of pushers 9 to trigger the plurality of fasteners 11 from the cartridge 15 as the set 34 of trigger cam bars is moved through the cartridge 15, as will be described in more detail in what follows.

The set 34 of trigger cam bars includes a first trigger cam rod 36 having an elongated configuration defined by left and right side walls 37a, 37b, having a distal end 38. Each of the left and right side walls 37a and 37b of the cam bar 36 includes a cam surface 33 having a first cam portion 39 and a second cam portion 40. Each of the first cam portions 39 is disposed distally and at an angle in relation to one of the second cam parts 40 that is defined along the bottom / bottom surface of the left and right side walls 37a, 37b. Only one of the second cam parts 40 can be seen in Figures 3-5. The configuration of the first cam parts 39 of the cam surface 33 facilitates the movement of the first jaw member 13 towards the second jaw member 17 from the separated position to the approximate position so that the tissue can be held as described. in more detail in what follows. The second cam parts 40 are elongated in comparison with the first cam parts 39 and narrow inwards at a distance "T" (Figure 5) in relation to a longitudinal axis "BB" of the first set 34 of cam bars shot towards a proximal end of the set 34 of trigger cam bars (figure 5). The narrowing "T" controls a distance of tissue separation between the first and second jaw members 13, 17 when the first and second jaw members 13, 17 are moved to the approximate position, as will be described here in more detail in Whats Next.

The distal end 38 of the first trigger cam rod 36 includes two contact surfaces 42a, 42b (figures 4 and 6), which are aligned with the plurality of pushers 9 of the cartridge 15 (figure 19). The contact surfaces 42a, 42b with pushers are configured to contact the plurality of pushers 9 to deploy the plurality of surgical fasteners 11 from the cartridge 15.

In the illustrated embodiment, the trigger cam bar assembly 34 includes a second or inner trigger cam rod 44 that is similar to the first trigger cam rod 36. The first and second bars 36, 44 of the trip cam form a mutually fitted configuration (as best seen in Figure 6). The second firing cam bar 44 has an elongated configuration defined by left and right side walls 45a, 45b, which have a distal end 46. Each of the left right side walls 45a and 45b of the cam bar 44 includes a surface of cam 53 having a first cam part 49 and a second cam part 50. The first cam parts 49 of the cam surface 53 are arranged distantly according to an angle in relation to the second cam parts 50 (only shown one of the second parts 50) of the cam surface 53. The distal end 46 of the second trip cam rod 44 includes two contact surfaces 48a, with pushers, which are aligned with the plurality of pushers 9 of the cartridge 15 to contact the plurality of pushers 9 to deploy the plurality of surgical fasteners 11 from the cartridge 15 (figure 19).

The first and second trip cam bars 36, 44 may be formed of any suitable material, including, but not limited to, plastic, metal, etc. In some embodiments, the first and second firing cam bars 36, 44 are formed of metal.

Although the set 34 of trip cam bars has been described herein as including first and second trip cam bars 36, 44, more or less trip cam bars can be used. For example, in some embodiments, the second trigger cam bar 44 may be omitted. In this particular embodiment, the configuration of the first trigger cam bar 36 of the trigger cam assembly 34 can be modified to include features of the second trigger cam rod 44. For example, the left and right side walls 37a, 37b of the first trigger cam bar 36 may be widened at the distal end 38 to align with the entire rows of the plurality of pushers 9 to eject the entire plurality of fasteners 11 disposed within the cartridge 15. Alternatively, the second trigger cam bar 44 can be omitted without changing the configuration of the first trigger cam rod 36.

Referring to FIGS. 7-13, a cantilever 52 (FIG. 13) is disposed at a proximal end of the first jaw member 13. The cantilever 52 may be monolithically formed with the first jaw member 13. Alternatively, the cantilever 52 can be formed as a separate component apart from the first jaw member 13 and coupled to the first jaw member 13 by means of one or more appropriate coupling methods, for example welding. The cantilever 52 is disposed adjacent the pivot assembly 30 between the lower coupling member 26b and a distal end of the articulation arm 32 (see Figure 9, for example).

In the illustrated embodiment, the overhang 52 is in the form of a bridge 54 that is formed between lateral projections 55a, 55b extending proximally from the proximal end of the first jaw member 13 (Figure 13). The bridge 54 is disposed transversely to the longitudinal axis "A-A" (figure 7) defined through the stem assembly 20 of the refill 10.

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The bridge 54 supports a cam member 57 (Figures 2 and 13) which is positioned so that the first and second cam portions 39, 49 and 40, 50, respectively, of the bars 36, 44 are slidably applied thereto. First and second trip cam when the set 34 of trigger cam bars is advanced distally within the cartridge 15, as will be described in more detail below. The cam member 57 may be inclined (as shown in the illustrated embodiment) or otherwise configured to operate in combination with the "T" narrowing of the second cam portions 40, 50 of the first and second bars 36, 44 of firing cams, respectively, to control the size of the tissue separation space between the first and second jaw members 13, 17 when the first and second jaw members 13, 17 are in the approximate configuration. The cam member 57 may be coupled to the bridge 54 by means of one or more appropriate coupling methods, for example adhesive, welding, etc. Alternatively, the cam member 57 may be omitted and the bridge 54 may be formed integral with a cam surface configured to control the size of the tissue separation space. In accordance with the present invention, the bridge 54 couples the trigger cam bars 36, 44 to close the first and second jaw members 13, 17 in both linear and articulated positions.

Referring to Figure 9, the overhang 52 defines an opening 58 between the lateral projections 55a 55b and the bridge 54. The opening 58 receives a rivet 59 (Figure 9) for attaching the lower coupling member 26b to the lower part 28b of the pivot assembly 30 during recharge manufacturing 10.

Referring to FIGS. 2, 14 and 15, an elastic member 56 is disposed in the cartridge 15 and positioned to load the cartridge 15 radially outwardly from the anvil 19, to the separate position. The elastic member 56 includes a proximal end 60 that is coupled to a proximal end of the cartridge 15 and a distal end 62 that is positioned to contact at least a portion of the anvil 19. In the illustrated embodiment, the proximal end 60 of the elastic member 56 includes two parts 64a, 64b of fingers that sit within two corresponding openings 66a, 66b of appropriate configuration, defined at the proximal end of the cartridge 15 (see Figures 2 and Figure 13).

Referring to Figures 16 and 17, during use, before placing the fabric between the first and second jaw members 13, 17, the tool assembly 14 is in the separate or approximate position. In this position, the distal ends 38, 46 of the first and second trigger cam bars 36, 44 are located proximally with respect to the plurality of pushers 9 and the plurality of fasteners 11. Also, in this configuration, a part of coupling of the first cam parts 39, 49 (see also Figure 6) of the first and second trigger bars 36, 44 is located proximally with respect to the cam member 57. As described above, the elastic member 56 is located to push the jaw member 13 towards the separate or non-approximate position.

Referring to Figure 18, when the set 34 of trigger cam bars is advanced distally, the first cam portions 39, 49 of the first and second trigger bars 36, 44 apply to cam member 57 of the bridge 54 and swing the first jaw member 13, including the cartridge 15, toward the anvil 19 of the second jaw member 17 to move the jaw member 13 that includes the cartridge 15 towards the fastened or approximate configuration. In this example, the cartridge is pivotally attached to the second jaw member. However, any of the embodiments described herein may have a first jaw member or a second jaw member or both, which are pivotally movable.

Referring to FIG. 19, the continuous distal translation of the trigger cam assembly 34 moves the distal ends 36, 48 of the first and second rod 36, 44 of contact cam cams with the plurality of pushers 9 sequentially to eject the plurality of fasteners 11 from the cartridge 15 and towards the anvil 19 to staple subject tissue. According to the present invention, when the assembly 34 of trip cam bars is moved through the cartridge 15, the application of the cam member 57 on the bridge 54 with the narrowing "T" (Figure 15) on the second parts of cam 40, 50 of the first and second bars 36, 44 of trigger cam controls the position of the fashion member 17 with respect to the jaw member 13 to selectively maintain a desired tissue separation distance between the first jaw members and second 13, 17 (figure 20). In accordance with the present invention, the degree of narrowing "T" in the second cam portions 40, 50 of the first and second trigger bars 36, 44 may be uniform or non-uniform to selectively control the separation distance of the tissue during translation of the cam bar assembly 34 through the cartridge 15. It should be noted that the narrowing "T" may define a positive or negative inclination in the proximal direction to provide the appropriate or desired distance of tissue separation.

The unique configuration of the jaw member 13, which includes the set 34 of trigger cam bars and the overhang 52, provides a simple design for the approximation and control of the tissue separation space between the cartridge 15 and the anvil 19. In addition, the tool assembly 14 currently described allows the tissue separation space between the first and second jaw members 13, 17 to be controlled exactly by the second cam portions 40, 50 of the first and second bars 36, 44 of trigger cam as the set 34 of trigger cam bars is advanced.

In some embodiments, the tool assembly 14 may be integrally formed with the device 12 of

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surgical performance. In this particular embodiment, the tool assembly 14 may be functionally coupled to an articulation assembly, for example the articulation assembly 30, which may be supported at a distal end of the rod assembly 16 of the surgical actuation device 12. Alternatively, the articulation assembly 30 may be omitted and the tool assembly 14 may be connected directly to the distal end of the rod assembly 16 of the surgical actuation device 12.

Figures 21-44 illustrate a refill 110 according to another embodiment of the present invention. Recharge 110 is configured for use with the stapler 212 shown in Figure 1B. Only features that are unique to recharge 110 will be described here.

Figure 22 is a perspective view of the recharge 110 with separate parts. The refill includes an outer tube 118 that houses a rod assembly 120 configured to engage the refill 110 with the rod assembly 216 of the actuation device 212 shown in Figure 1B. The rod assembly 120 includes an upper housing part 122a and a lower housing part 122b which, when coupled to each other, house components of the refill 110. The proximal ends 124a, 124b of the upper and lower housing parts 122a, 122b, respectively, are configured to releasably engage the distal end of the rod assembly 216 of the actuation device 212 (see, for example, the '361 patent). A distal end of the rod assembly 120 includes a pair of upper and lower coupling member 126a, 126b that are configured to couple the rod assembly 120 to the upper and lower pivot portions 128a, 128b, respectively, of a pivot assembly 130 (see figure 21). An articulation arm 132 is slidably located inside the upper and lower housing parts 122a, 122b and is configured to articulate an end assembly 114 of the recharge tool or actuator 110 with respect to a longitudinal axis "CC" (figure 21) defined through the stem assembly 120.

Referring to Figures 22-24, the tool assembly 114 includes a first jaw member 113 that supports a cartridge 115 that houses a plurality of pushers 109 and fasteners 111, and a second jaw member 117 that supports an anvil 119. The cartridge 115 supports an elastic member 156 that is positioned to load the cartridge 115 radially outwardly from the anvil 119 to an approximate or separate configuration. The elastic member 156 includes a base part 160 (Figure 24) that is coupled to a proximal end of the cartridge 115 and an upper part 162 located to contact at least a part of the anvil 119. The base part 160 of the elastic member 156 it is seated within a corresponding slot 165 defined at the proximal end of the cartridge 115 and includes one or more collars 163 (a collet 163 is shown in the figures) that are received in corresponding depressions 166 arranged in the cartridge 115 adjacent to slot 165 to attach the elastic member 156 to the cartridge 115.

Referring to Figures 25 and 26, the second jaw member 117 includes a pair of upper rails 121a, 121b extending longitudinally along an inner wall portion 123 of the second jaw member 117. The upper rails 121a, 121b are separated by an elongate groove 125 that extends along the length of the upper rails 121a, 121b. The upper rails 121a, 121b are located along the inner wall part 123 proximal to where the upper part 162 of the elastic member 156 contacts the inner wall part 123 of the jaw member 117 (see Figure 35, for example ). A dissection tip 157, such as that described in the '123 patent, may be secured to a distal end of the second jaw member 117 to facilitate placement of the second jaw member 117 with respect to the tissue to be stapled.

Referring to Figures 27 and 28, the recharge 110 (Figure 21) includes a drive beam assembly 134 formed of a plurality of drive beam portions 135 that are coupled to each other to form a drive beam 136. One end The working beam assembly 134 includes an I-beam 137 that is coupled to the distal end of the driving beam portions 135 and includes upper and lower flanges or wings 139a, 139b, respectively, connected to each other by means of a post 139c. Unlike conventional I-beams, the I 137 beam does not include a blade and cutting blade at the leading edge of post 139c, since the I 137 beam is not configured to cut stapled tissue. The beam in I 137 is movable through tool assembly 114 to approximate the first and second jaw members 113 and 117 and eject fasteners 111 from cartridge 115 as will be described in more detail in the following. The upper flange 139a is located within the second jaw member 117 (Figure 26) above the rails 121a, 121b. When the drive beam 136 of the drive beam assembly 134 is displaced distally within the second jaw member 117, the upper flange 139 slides above the upper flange 139a to prevent movement out of the second jaw member 117 in relation to the first jaw member 113. Similarly, the post 139c of the I-beam is located through an elongated groove 127 (see Figure 31) which is defined through the first jaw member 113 such that the lower flange 139b is slidable along an outer surface of the first jaw member 113 to prevent movement out of the first jaw member 113 with respect to the second jaw member 117. A notch 129 is defined through a wall side of post 139c, the meaning of which will be described in more detail in the following.

A latch assembly 140 is coupled to a proximal end of the drive beam assembly 134. The latch assembly 140 includes a latch body 141 that includes a collar 142 defining lower grooves and

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upper 144 (only upper slot 144 shown). The grooves 144 are configured to receive a proximal end of the drive beam 136. A longitudinal opening 146 of suitable configuration is defined through the collar 142 and is generally in alignment with an elongated proximal part 148 of the latch body 141. The body 141 of the latch of the latch assembly 140 includes a pair of opposing support members 149a, 149b, which support a pivot pin 151. A projection 170 extends upwardly from the latch body of the latch assembly 140 adjacent to the collar 142 and is configured to support a spring 171.

The latch assembly 140 includes a latch 150 which has a generally elongated configuration that includes a distal part 152, a middle part 154 and a proximal part 158. A transverse opening 153 extends through the middle part 154 and is configured to receive the pivot pin 151 for pivotally securing the latch 150 to the body 141 of the latch of the latch assembly 140. The distal portion 152 of the latch 150 is positioned to contact the spring 171 such that the spring 171 pushes a proximal end 172 of the proximal part 158 of the latch 150 downwards, towards the proximal part 148 of the latch assembly 140 (as best shown in Figure 27). A projection 164 is disposed on a lower surface and at the proximal end 172 of the proximal part 158 of the latch assembly 150. A lateral displacement extension 173 is also arranged at the proximal end 172 of the latch assembly 150 and is configured to move the latch 150 facing up against the loading of the spring 171, as will be described in more detail in the following.

Referring to Figures 29 and 30, a slide pusher assembly 174 is illustrated. The slide pusher assembly 174 includes an elongate support member 176 having a distal end that is applied to the slide pusher 178 and a proximal end that supports a coupling assembly 180. The distal end of the support member 176 defines a groove 181 and a pair of openings 182 (only one opening 182 shown). The openings 182 extend through the slit 181 and receive a pin 183, rivet or the like. The slit 181 is configured to receive a proximal end of the slide pusher 178. The pin 183 extends through an opening 186 defined through the proximal end of the slide pusher 178 to secure the slide pusher 178 to the support member 176. As can be seen, other coupling methods can also be used for coupling the slide pusher 178 to the support member 176.

An opening 184 is arranged in the upper member 176. The opening 184 is configured to receive the projection 164 of the latch 150 in such a way that the projection 164 contacts a proximal wall portion 185 defining the opening 184 (Figure 33). In accordance with the present invention, when the projection 164 is in contact with the proximal wall portion 185, the slide pusher assembly 174 and the drive beam assembly 134 are mutually releasably coupled such that the movement of the Sliding pusher assembly 174 performs the corresponding movement of the drive beam assembly 134 to effect the movement of the first jaw member 113 towards the second jaw member 117.

Referring also to Figures 32 and 33, the lower housing part 122b supports the drive assembly 134 which includes the latch assembly 140 and the sliding pusher assembly 174. The lower housing part 122b is configured to de-apply the latch 150 of the latch assembly 140 of the sliding pusher assembly 174 to allow additional distal translation of the sliding pusher assembly 174, regardless of the drive beam assembly 134. Specifically , a ramp part 188 is arranged along an upper wall 189 of the lower housing part 122b. The ramp portion 188 is configured to contact the lateral displacement extension 173 of the latch 150 to pivot the latch 150 around the pivot member 151 to raise the projection 164 of the latch 150 out of engagement with the opening 184 of the support member 176 of the sliding pusher assembly 174 when the drive beam assembly 134 and the sliding pusher assembly 174 are moved distally to approximate the jaw members 113 and 117.

A pair of stops 190a are arranged along an inner wall part 191 of the lower housing part 122b. The stops 190a are positioned to contact a lower part of the collar 142 of the latch assembly 140 to prevent further distal translation of the drive beam assembly 134 after the collar 142 has been applied to the stops 190a. In the illustrated embodiment, a corresponding pair of stops 190b (Figure 39) are arranged in the upper housing part 122a and are configured to contact a top part of the collar 142 of the latch assembly 140 to avoid further distal translation of the assembly of drive beam 134 after collar 142 has been applied to stops 190a.

Figures 34-44 illustrate the operation of the recharge 110. Referring to Figures 33-35, before placing the fabric between the first and second jaw members 113, 117, the tool assembly 114 is pushed into the separate position or approximated by the elastic member 156 that contacts the inner wall 123 of the second jaw member 117 (Figures 34 and 35). In the separate position, the projection 164 of the latch 150 is in contact with the proximal wall portion 185 that defines the opening 184 in the support member 176 to releasably engage the slide pusher assembly 174 to the drive beam assembly 134 such that the distal translation of the slide pusher assembly 174 effects the corresponding movement of the drive beam assembly 134.

In the separate position of the jaw members 113 and 117, the distal end of the support member 176 is

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located through the longitudinal opening 146 of the collar 142 of the latch assembly 140 and the slide pusher 178 is located within the groove 129 of the post 139c of the I-beam 137 to align the distal end 193 of the slide pusher 178 with a slide 187 that is arranged in the cartridge 115 (figure 35). The distal end 193 of the slide pusher 178 is designed to be applied to a proximal end 195 of the slide 187 when the slide pusher 178 is moved distally towards the cartridge 115. In the illustrated embodiment, the distal end 193 of the pusher of slide 178 and proximal end 195 of slide 187 include complementary configurations, for example, spherical configurations, to facilitate coupling between them. The slide 187 is configured to sequentially contact the plurality of pushers 109 to eject the plurality of fasteners 111 from the cartridge 115, as is known in the art.

Referring to Figures 36-41, when the surgical actuation device 12 (Figure 1B) is actuated to advance the slide pusher assembly 174, the actuator assembly 134, which is releasably coupled to the pusher assembly 174 of the slide, it is advanced in the distal direction to move the beam in I 137 in the distal direction with respect to the tool assembly 114. As the beam in I is moved distally, the upper and lower flanges 139a, 139b of the beam in I 137 are applied to the first and second jaw members 113, 117, respectively, such that the first jaw member 113 is moved towards the second jaw member 117, to the held or approximated position of the tool assembly 114 for hold the fabric (figure 36). As noted above, the drive assembly 134 and the slide pusher assembly 174 move into the cone due to the projection 164 being in contact with the proximal wall portion 185 defining the opening 184 of the support member 176.

When the drive assembly 134 is moved distally to move the jaw members 113 and 117 toward the secured or approximate position, the lateral displacement extension 173 (Figure 38) of the latch 150 slides upward along the ramp 188 of the lower housing part 122b and raises the latch 150 to disengage the shoulder 164 of the coupling latch 140 with the proximal wall portion 185 of the support member 176. In the approximate position of the jaw members 113 and 117, the assembly 174 The slide pusher is disengaged from the drive assembly 134 and the distal end 193 of the slide pusher 178 is positioned in engagement with the proximal end 195 of the slide 187 (as best shown in Figure 41).

In the approximate position, the collar 142 is in contact with the stops 190a of the lower housing part 122b (Figures 38 and 42) and the upper part of the collar 142 is in contact with the stops 190b of the upper housing part 122a. The coupling between the stops 190a and the collar 142 prevents further distal movement of the drive beam assembly 134.

Referring to Figures 42-44, after the sliding pusher assembly 174 of the drive assembly 134 has been disengaged, the additional actuation of the actuation device 12 effects the independent movement of the sliding pusher assembly 174 through the opening 146 of collar 142 such that the distal end 193 of the slide pusher 178 moves distally with respect to the I-beam 137 of the drive assembly 134 to advance the slide 187 through the cartridge 115 in sequential engagement with the pushers 109 to eject the plurality of fasteners 111 from the cartridge 115 (figures 43 and 44).

Although the refills 10, 110 have been described herein as configured for use with the stapler 212, it is within the scope of the present invention that the operational components of the reloads 10, 110 can be incorporated into a stapler with a set of tool firmly attached to it.

The stapler 212, with any of the recharges 10, 110 attached thereto, can be used to staple various tissue structures. For example, during a transplant operation, when blood flows through the vascular structure adjacent to a transplant site, it needs to be controlled or inhibited, stapler 212 can be used to staple (i.e. occlude) this vascular structure, controlling with it and / or inhibiting blood flow through the vascular structure. It is contemplated that the stapler 212, with any of the recharges 10, 110 attached thereto, can be used to staple other types of tissue structures and / or be used in relation to other surgical operations.

Although several embodiments of the invention have been shown in the drawings, it is not intended that the invention be limited thereto, since it is intended that the invention be as wide in scope as the technique allows and that the memory be read in a similar manner . Therefore, the above description should not be considered as limiting, but simply as examples of particular embodiments. Those skilled in the art will devise other modifications within the scope of the claims appended hereto.

Claims (15)

5 10 fifteen twenty 25 30 35 40 Four. Five fifty 55 1. A surgical stapling device, comprising: an actuation device (12) that includes an elongated rod (16); a tool assembly (10, 110) disposed at a distal end (114) of the rod, the tool assembly including a first jaw member (113) supporting a cartridge assembly (115) having a plurality of fasteners or clips (111) and a slide located to eject the fasteners from the cartridge assembly, and a second jaw member (117) supporting an anvil (119), the first jaw member being movable with respect to the first jaw member between positions separate and approximate; a slide pusher assembly (174) that includes a slide pusher (178) having a distal end configured to be applied to the slide of the cartridge assembly; Y a drive beam assembly (134); characterized in that the drive beam assembly includes a latch assembly (140) having a latch (150) releasably coupled to the slide pusher assembly, wherein the distal translation of the drive beam assembly from a retracted position towards an advanced position effects the movement of the first and second jaw members towards the approximate position and de-applies the latch, of the latch assembly, of the pusher assembly of slide to facilitate distal movement of the slide pusher regardless of the drive beam assembly and in which the distal motion of the slide pusher regardless of the drive beam assembly advances the slide pusher and the slide of the cartridge assembly to eject the plurality of fasteners from the cartridge assembly. 2. The surgical stapling apparatus according to claim 1, wherein the latch assembly includes a collar (142) that is coupled to a proximal end of the drive beam assembly and includes an opening (184) configured to receive a support member (176) of the slide pusher assembly; wherein, preferably, the support member of the slide pusher assembly includes at least one opening that is configured to receive the latch of the latch assembly. 3. The surgical stapling apparatus according to claim 1 or 2, wherein the drive beam assembly includes a double T beam beam (137) having a side wall defining a notch, the slide pusher being received inside the notch; wherein, preferably, the I-beam is located to drive the first and second jaw members to cam towards the approximate position when the drive beam assembly is moved distally. 4. The surgical stapling apparatus according to claim 2, wherein the latch assembly includes at least one spring (171) configured to load the latch of the latch assembly into the opening defined in the support member of the assembly sliding pusher; wherein, preferably, the opening of the support member is defined by a proximal wall portion of the slide pusher assembly, the proximal wall portion being configured to be applied to the latch of the latch assembly to keep mutually coupled to the beam assembly drive and slide pusher. 5. The surgical stapling apparatus according to claim 2, wherein the elongated rod includes upper and lower housing parts (122a, 122b), and at least one of the upper and lower housing parts includes at least one member stop (190a, 190b) configured to contact a proximal end of the collar of the latch assembly when the drive beam assembly is moved distally; in which, preferably, the latch includes a lateral displacement extension, and in which at least one of the upper and lower housing parts of the elongated rod includes at least one ramp portion configured so that the extension of lateral displacement to effect the movement of the latch out of engagement with the proximal wall part when the drive beam assembly is moved distally so that the sliding pusher assembly is allowed to move distally with respect to the drive beam assembly . 6. The surgical stapling apparatus according to any of the preceding claims, wherein an elastic member (56) is disposed in the cartridge assembly for loading the cartridge assembly radially out of the anvil; wherein, preferably, the elastic member includes a lower part that is coupled to a proximal end of the cartridge assembly and an upper part that is positioned to contact at least a part of the anvil; wherein, preferably, the lower part of the elastic member is seated within a corresponding groove defined at the proximal end of the cartridge assembly. 7. The surgical stapling apparatus according to claim 6, wherein the lower part of the elastic member includes at least one fastener that engages a corresponding depression disposed in the assembly of 5 10 fifteen twenty 25 30 35 40 Four. Five fifty 55 cartridge adjacent to the slot. 8. The surgical stapling apparatus according to any preceding claim, wherein the tool assembly is detachably attachable to the distal end of the rod of the surgical stapling apparatus. 9. A recharge (10, 110) configured for use with a surgical stapling device, the recharge comprising: a rod (20) that includes a proximal end and a distal end, the proximal end being adapted to engage a surgical apparatus; a tool assembly disposed at the distal end of the rod, the tool assembly including a first jaw member that supports a cartridge assembly having a plurality of fasteners and a slide located to eject the fasteners from the cartridge assembly, and a second jaw member supporting an anvil, being the first movable jaw member with respect to the second jaw member between separate and approximate positions; a slide pusher assembly that includes a slide pusher having a distal end configured to be applied to the slide of the cartridge assembly; Y a drive beam assembly; characterized in that the drive beam assembly includes a latch assembly having a latch releasably coupled to the slide pusher assembly, in which the distal translation of the drive beam assembly from a retracted position to an advanced position effects the movement of the first and second jaw members towards the approximate position and disengages the latch of the slide pusher assembly latch assembly for facilitate the distal movement of the slide pusher regardless of the drive beam assembly, and in which the distal movement of the slide pusher regardless of the drive beam assembly advances the distal end of the slide pusher to engage with the slide of the cartridge assembly to eject the plurality of fasteners from the cartridge assembly. 10. The recharge according to claim 9, wherein the latch assembly includes a collar that is coupled to a proximal end of the drive beam assembly and includes an opening configured to receive a support member of the pusher assembly. slide; wherein, preferably, the support member of the slide pusher assembly includes at least one opening that is configured to receive the latch of the latch assembly. 11. The recharge according to claim 9 or 10, wherein the drive beam assembly includes an I-beam having a side wall defining a notch, the sliding pusher being received within the notch; wherein, preferably, the I-beam is located to drive the first and second jaw members to cam towards the approximate position when the drive beam assembly is moved distally. 12. The recharge according to claims 9 to 11, wherein the latch assembly includes at least one spring configured to load the latch of the latch assembly into the opening defined in the support member of the slide pusher assembly; wherein, preferably, the opening of the support member is defined by a proximal wall portion of the slide pusher assembly, the proximal wall portion being configured to be applied to the latch of the latch assembly to maintain the drive beam assembly and the sliding pusher coupled between sf. 13. The refill according to any of claims 9 to 12, wherein the elongated rod includes upper and lower housing parts, and at least one of the upper and lower housing parts includes at least one stop member configured for contacting a proximal end of the collar of the latch assembly when the drive beam assembly is moved distally; wherein, preferably, the latch includes a lateral displacement extension, and in which at least one of the upper and lower housing parts of the elongated rod includes at least one ramp portion configured so that the extension of lateral displacement to effect the movement of the latch out of engagement with the proximal wall part when the drive beam assembly is moved in a distal direction such that it allows the sliding pusher assembly to move in a distal direction with respect to the beam assembly of drive 14. The refill according to any of claims 9 to 13, wherein the elastic member is disposed in the cartridge assembly to load the cartridge assembly radially out of the anvil; wherein, preferably, the elastic member includes a bottom portion that is coupled to a proximal end of the cartridge assembly, and a stop portion that is positioned to contact at least a portion of the anvil. 15. The refill according to claim 14, wherein the lower part of the elastic member is seated within a corresponding groove defined at the proximal end of the cartridge assembly; and / or wherein the lower part of the elastic member includes at least one fastener that engages a corresponding depression disposed in the cartridge assembly adjacent to the groove.